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Why Do Individual Practices Fail?


Article-Why-Do-Individual-Practices-Fail

The Struggle of Individual Practices

Fewer doctors are opting to run their individual practices, with most of them seeking jobs in hospitals or larger medical groups, according to the CMS research report. This shift away from private practices towards employment is consistent throughout the country. Private practices were hit hard by the economic impact of the early pandemic as patient volume and revenues shrank while medical supply expenses spiked. The impact of these economic forces on individual practices is ongoing and may not be fully realized for some time. But still, recent years have seen a stampede of physicians accepting buyout offers from hospitals and other large providers.

McKinsey & Company recent survey report highlighted findings. 53 percent of independent doctors reported that they were worried about their practices surviving the stresses of the pandemic. The Physicians Foundation found that 62 percent of physicians were independent in 2008. But by 2014 that number had dropped to 35 percent, a swift decline in such a short timeframe. The AMA surveyed 3,500 U.S. doctors through the 2020 Physician Practice Benchmark Survey. The percentage of doctors in private practice declined at a slower rate in previous AMA surveys, slipping to 49.1 percent in 2020, 55.8 percent in 2016 from 56.8 percent in 2018, and 60.1 percent in 2012.

Challenges for Individual Practices

Financial Liability

More and more younger doctors are seeking employment, it’s not just money leading to the shift away from individual practice. Many recent graduates of medical schools have significant debt and are more likely to opt for employment, which offers more financial stability and work-life balance. Hospitals face competition for doctors from insurers, which have been looking in some cases to directly employ more physicians. The AHA report cites insurance giant UnitedHealth Group’s Optum unit as the most visible example of this trend. With technological enhancements, patients also expect ways to connect with providers virtually and receive appointment reminders on their cell phones. Younger doctors may not be able to invest in such technologies and tools, straight after graduating from medical school.

Affordable Care Act

Challenges in front of individual practices are many but two factors under the Affordable Care Act are the hardest ones. The first is the financial incentives that favor consolidation over independence. The second is the law’s increased regulatory burden, which threatens to overwhelm individual practices. These two factors are related. The Affordable Care Act made mandatory a number of cost and health outcome reporting requirements for physicians who see Medicare patients, which is about 90 percent of us. Failure to comply results in slashed reimbursement rates that run as high as 6 percent. Yet the additional administrative burden of participating in these programs falls hardest on small individual practices, which, perversely, are also subject to the stiffest penalties.

Over Working

Hiring and retaining support staff is a costly affair. So most individual practice owners try to do everything on their own. Due to this, the doctor starts overworking in areas that don’t directly generate revenue like opening the mail, answering the phone, and scheduling patients.

Many doctors, instead of hiring based on skills, personality, or prior experience, hire someone who is like them or someone they know. This could lead to inefficiencies in your office management and you have to pitch in every time to sort of things. As a healthcare provider, you want to dedicate the maximum of your time to patient care, which may not be possible due to unskilful staff. Overworked individuals won’t get the satisfaction of working hard, as most of their time is wasted on administrative work activities.

Receive Accurate Reimbursements

Medical billing and coding is a specialized field and practices need RCM experts to receive timely and accurate reimbursements. Most individual practices try to coding and billing all by themselves and could stuck in a vicious cycle of claim denials and appeals. For any healthcare practice sound, financial health ensures the funds for the day-to-day operations of the practice. Medical billing and insurance reimbursement policies keep on updating on regular basis, providers who are busy in patient care, can't able to track them and bill accordingly. Outsourcing medical billing services could be a great option for individual practices as it’s surprisingly cost-effective. You can contact Medical Billers and Coders (MBC) at 888-357-3226 / info@medicalbillersandcoders.com to know more about how to receive accurate reimbursements from various insurance carriers.

We won’t need a survey report to confirm that individual practices are declining and ever-increasing operational cost is playing a major role in it. Partnering with the medical billing company is need of an hour for individual practices. Medical billing companies ensure that individual practices receive timely and accurate reimbursements and that providers can focus on patient care. This article is shared by Medical Billers and Coders (MBC), a leading medical billing company, with the purpose of healthcare provider education. If you want to partner with us for complete RCM services, contact us at: 888-357-3226 / info@medicalbillersandcoders.com.

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